Home-based Diagnosis of Obstructive Sleep Apnea in an Urban Population

Garg, Navneet; Rolle, Andrew J.; Lee, Todd A.; Prasad, Bharati

doi:10.5664/jcsm.3960

Cited by 70 publications

(57 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When two studies evaluated the home-based PAT device against in-laboratory PSG at an AHI cutoff of ≥ 15, specificity ranged from 0.77 to 1.00 and sensitivity ranged from 0.92 to 0.96. 105,106 A single study evaluated the PAT device at an AHI cutoff of ≥ 30, and reported a specificity of 0.82 (95% CI: 0.57 to 0.96) and sensitivity of 0.92 (95% CI: 0.62 to 1.00) 105 (see supplemental material, Table S55 through Table S57). …”

Section: Accuracymentioning

confidence: 99%

“…104 Two cross-over studies randomized patients to home-based PAT, and in-laboratory simultaneous PSG and PAT. 105,106 For comparison to in-laboratory PSG, only the home-based PAT data were used for this recommendation. A single study that evaluated the performance of the PAT device in the home against in-laboratory PSG using a cutoff of AHI ≥ 5, 106 reported a specificity of 0.43 (95% CI: 0.22 to 0.66).…”

Section: Accuracymentioning

confidence: 99%

See 1 more Smart Citation

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,124

1,498

View full text Add to dashboard Cite

Introduction: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use. In addition, the task force adopted foundational recommendations from prior guidelines as "good practice statements", that establish the basis for appropriate and effective diagnosis of OSA. The AASM Board of Directors approved the final recommendations. Recommendations:The following recommendations are intended as a guide for clinicians diagnosing OSA in adults. Under GRADE, a STRONG recommendation is one that clinicians should follow under most circumstances. A WEAK recommendation reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. Good Practice Statements:Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation. Recommendations:1. We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG) 2. We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG) 3. We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG) 4. We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. (STRONG) 5. We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protoc...

show abstract

Section: Accuracymentioning

confidence: 99%

Section: Accuracymentioning

confidence: 99%

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,124

1,498

View full text Add to dashboard Cite

show abstract

“…A heart rate-based apnea/hypopnea evaluation, a respiratory sound-based apnea/hypopnea evaluation, or a pulse attenuation evaluation for apnea/hypopnea events are surrogates. 6 Surrogates may serve very well against the reference standard and may do their job well in clinical practice. 6 For summing up these surrogates the term "respiratory disturbance index (RDI)" was coined, being different from AHI.…”

Section: Apnea Hypopnea Rdi Surrogatesmentioning

confidence: 99%

“…6 Surrogates may serve very well against the reference standard and may do their job well in clinical practice. 6 For summing up these surrogates the term "respiratory disturbance index (RDI)" was coined, being different from AHI. This opens our eyes to the problem that nasal prongs or thermal sensors provide surrogates for airfl ow as well.…”

Section: Apnea Hypopnea Rdi Surrogatesmentioning

confidence: 99%

Revise Respiratory Event Criteria or Revise Severity Thresholds for Sleep Apnea Definition?

Penzel

Schöbel

Fietze

2015

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

“…32 This device is validated for the diagnosis of OSA. 22,[33][34][35][36] The PAT signal is a measure of sympathetic activity and is augmented, along with an increase in the heart rate and a decrease in oxygen saturation, at the termination of a respiratory event. 32,34 Using the above measurements, this device can indirectly detect respiratory events.…”

mentioning

confidence: 99%

Home Sleep Tests for Obstructive Sleep Apnea (OSA)

Kapoor

Greenough

2015

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is a fairly common condition that, if left untreated, can lead to complications such as high blood pressure and heart disease. Polysomnography (PSG) is the most accurate method for diagnosing OSA, but it is a cumbersome and expensive test. A well-validated, easier to perform and less expensive alternative is the home sleep test (HST). The purpose of this review is to educate the primary care provider about the important differences between PSG and HSTs, the advantages and limitations of both modalities, identifying patients who are appropriate candidates for the HST, identifying patients in whom the HST should not be performed, and further evaluation of patients who have a negative HST. (J Am Board Fam Med 2015;28:504 -509.)

show abstract

Home-based Diagnosis of Obstructive Sleep Apnea in an Urban Population

Cited by 70 publications

References 44 publications

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Revise Respiratory Event Criteria or Revise Severity Thresholds for Sleep Apnea Definition?

Home Sleep Tests for Obstructive Sleep Apnea (OSA)

Contact Info

Product

Resources

About